Surgical access port

ABSTRACT

A surgical access port or trocar is provided. The trocar has a trocar seal housing and a trocar cannula with an optical obturator insertable through the trocar seal housing and the trocar cannula. The trocar is configured to access a body cavity, to maintain positive pressure and to prevent loss of surgical insufflation gas used in laparoscopic procedures. The trocar seal housing can be releasably attached to the trocar cannula. The trocar seal housing may also have a shield and/or alignment channel that provide protection or assist in operation of instrument and zero seals housed in the trocar seal housing.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.11/549,926 entitled “SURGICAL ACCESS PORT,” filed Oct. 16, 2006,currently pending, which claims the benefit of U.S. ProvisionalApplication Nos. 60/726,825, filed Oct. 14, 2005, and 60/828,515, filedOct. 6, 2006, the disclosures of all of which are hereby incorporated byreference as if set forth in full herein.

BACKGROUND

Laparoscopic surgery is commonly performed using access ports ortrocars, which provide instrument access across an abdominal wall andinto a gas pressurized abdominal cavity. Trocar seals within the trocarsallow instrument changes with no or minimal loss in gas pressure. Suchseals should be very durable even when challenged by the insertion ofsharp-pointed instruments. They should be capable of accommodating awide range of inserted instrumentation without leaking. They should benearly friction-free so that they do not interfere with the action ofthe instrument. And they should not damage the inserted instruments. Inaddition, they should be cost-effective and user-friendly, and not addto the complexity of a surgical procedure. Also, due to the inherentlimited confines of laparoscopic surgery, a continuing effort to reducefacial defects and to reduce interference between trocars, smaller orcompact trocars are desirable while still providing the above-notedfunctionalities or enhanced functionalities.

Laparoscopic surgery is an evolving modality. Significant changes ininstrumentation continue to challenge the trocar seals presently in use.Accordingly, there remains a continuing need to extend the range,durability and sensitivity of trocar seals.

SUMMARY

Generally, the present invention provides surgical access port or trocarwith a low-profile seal housing releasable from a cannula capable ofaccommodating an optical obturator. In one aspect, a surgical accessport comprises a trocar seal housing having at least one seal, a trocarcannula having a lumen, the at least one seal arranged to seal the lumenand a trocar lock releasably connecting the trocar cannula to the sealhousing and being one of slidably and pivotably connected to one of thetrocar seal housing and trocar cannula.

In one aspect, a surgical access port comprises a trocar seal housinghaving an instrument seal, a zero seal and an alignment channel with agenerally funneled entry. The zero seal is fixed to the trocar sealhousing and the instrument seal is positioned between the alignmentchannel and the zero seal and is pivotably connected to the seal housingand a trocar cannula is attached to the trocar seal housing.

In one aspect, a surgical access port comprises a trocar seal housinghaving an instrument seal, a zero seal, a shield and an alignmentchannel with a generally funneled entry. The zero seal is fixed to thetrocar seal housing, the instrument seal is positioned between thealignment channel and the zero seal and is connected to the sealhousing. The shield is positioned between the alignment channel and theinstrument seal and a trocar cannula is attached to the trocar sealhousing.

Many of the attendant features of the present invention will be morereadily appreciated as the same becomes better understood by referenceto the foregoing and following description and considered in connectionwith the accompanying drawings in which like reference symbols designatelike parts throughout.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a front view of a surgical access port in accordance withvarious aspects of the present invention;

FIG. 2 is a side view of a surgical access port in accordance withvarious aspects of the present invention;

FIG. 3 is a front view of a surgical access port without an opticalobturator in accordance with various aspects of the present invention;

FIG. 4 is a side view of a surgical access port without an opticalobturator in accordance with various aspects of the present invention;

FIG. 5 is a cross-sectional view taken along section lines 5-5 of FIG. 4in accordance with various aspects of the present invention;

FIG. 6 is an enlarged cross-sectional side view of a surgical accessport without an optical obturator in accordance with various aspects ofthe present invention;

FIG. 7 is front view of a trocar seal housing detached from a trocarcannula in accordance with various aspects of the present invention;

FIG. 8 is side view of a trocar seal housing detached from a trocarcannula in accordance with various aspects of the present invention;

FIG. 9 is a cross-sectional side view of a surgical access port withoutan optical obturator in accordance with various aspects of the presentinvention;

FIG. 10 is a perspective view of a lock ring in accordance with variousaspects of the present invention;

FIG. 11 is a cross-sectional side view of a surgical access port withoutan optical obturator in accordance with various aspects of the presentinvention;

FIG. 12 is a perspective view of a lock ring in accordance with variousaspects of the present invention;

FIG. 13 is a perspective view of a lock ring in accordance with variousaspects of the present invention;

FIG. 14 is a perspective view of a lock ring in accordance with variousaspects of the present invention;

FIG. 15 is a perspective view of a lock ring in accordance with variousaspects of the present invention;

FIG. 16 is a side view of a surgical access port without an opticalobturator and partially shown cannula in accordance with various aspectsof the present invention;

FIG. 17 is a cross-sectional side view of a surgical access port withoutan optical obturator and partially shown cannula in accordance withvarious aspects of the present invention;

FIG. 18 is a cross-sectional side view of a surgical access port withoutan optical obturator and partially shown cannula in accordance withvarious aspects of the present invention;

FIG. 19 is a side view of a surgical access port without an opticalobturator and partially shown cannula in accordance with various aspectsof the present invention;

FIG. 20 is a cross-sectional side view of a surgical access port withoutan optical obturator and partially shown cannula in accordance withvarious aspects of the present invention;

FIG. 21 is a cross-sectional side view of a surgical access port withoutan optical obturator and partially shown cannula in accordance withvarious aspects of the present invention;

FIG. 22 is a top view of a portion of socket lock in accordance withvarious aspects of the present invention;

FIG. 23 is a perspective view of a socket lock in accordance withvarious aspects of the present invention;

FIG. 24 is a perspective view of a socket lock in accordance withvarious aspects of the present invention;

FIG. 25 is a perspective view of a partially shown trocar cannula inaccordance with various aspects of the present invention;

FIG. 26 is a perspective view of a trocar seal housing and socket lockin accordance with various aspects of the present invention;

FIG. 27 is a perspective view of a return spring in accordance withvarious aspects of the present invention;

FIG. 28 is a cross-sectional side view of a surgical access port withoutan optical obturator and partially shown cannula in accordance withvarious aspects of the present invention;

FIG. 29 is a perspective view of a surgical access port in a lockedcondition without an optical obturator and partially shown cannula inaccordance with various aspects of the present invention;

FIG. 30 is a perspective view of a surgical access port in an unlockedcondition without an optical obturator and partially shown cannula inaccordance with various aspects of the present invention;

FIG. 31 is a top view of a gate lock in accordance with various aspectsof the present invention;

FIG. 32 is a cross-sectional side view of a surgical access port withoutan optical obturator and partially shown cannula in accordance withvarious aspects of the present invention;

FIG. 33 is a cross-sectional top view of a surgical access port withoutan optical obturator and partially shown cannula in accordance withvarious aspects of the present invention;

FIG. 34 is a cross-sectional side view of a surgical access port withoutan optical obturator and partially shown cannula in accordance withvarious aspects of the present invention;

FIG. 35 is a perspective view of lock levers in accordance with variousaspects of the present invention;

FIG. 36 is a cross-sectional side view of a surgical access port withoutan optical obturator and partially shown cannula and seal housing inaccordance with various aspects of the present invention;

FIG. 37 is a cross-sectional side view of a surgical access port withoutan optical obturator and partially shown cannula and seal housing inaccordance with various aspects of the present invention;

FIG. 38 is a cross-sectional side view of a surgical access port withoutan optical obturator and partially shown cannula and seal housing inaccordance with various aspects of the present invention;

FIG. 39 is a cross-sectional side view of a trocar seal housing inaccordance with various aspects of the present invention;

FIG. 40 is an exploded view of a trocar seal housing in accordance withvarious aspects of the present invention;

FIG. 41 is a cross-sectional side view of a trocar seal housing inaccordance with various aspects of the present invention;

FIGS. 42-43 are plan views of a trocar seal housing in accordance withvarious aspects of the present invention;

FIGS. 44-45 are plan views of a trocar seal housing in accordance withvarious aspects of the present invention;

FIG. 46 is a cross-sectional side view of a trocar seal housing inaccordance with various aspects of the present invention;

FIG. 47 is a front view of an optical obturator in accordance withvarious aspects of the present invention;

FIG. 48 is a side view of an optical obturator in accordance withvarious aspects of the present invention;

FIG. 49A is an exploded view of an optical obturator in accordance withvarious aspects of the present invention;

FIG. 49B is a longitudinal cross section of the shaft of the obturatorillustrated in FIG. 49A;

FIG. 50 is a front view of a surgical access port without an opticalobturator in accordance with various aspects of the present invention;

FIG. 51 is a side view of a surgical access port without an opticalobturator in accordance with various aspects of the present invention;

FIG. 52 is a cross-sectional view taken along section lines 52-52 ofFIG. 51 in accordance with various aspects of the present invention;

FIG. 53 is a cross-sectional side view of a trocar seal housing inaccordance with various aspects of the present invention;

FIG. 54 is a front view of a surgical access port in accordance withvarious aspects of the present invention; and

FIG. 55 is a side view of a surgical access port in accordance withvarious aspects of the present invention.

DETAILED DESCRIPTION

A surgical access port, e.g., a trocar, which comprises a trocar sealhousing, a trocar cannula, and/or an optical obturator is provided. Inthis description, “proximal” or “proximally” refers to that portion ofthe instrument, component, or element that extends toward the user.“Distal” or “distally” refers to that portion of the instrument,component, or element that extends away from the user. The trocar isconfigured to access a body cavity and to maintain positive pressure atits distal end to prevent loss of surgical insufflation gas such ascarbon dioxide used, for example, in laparoscopic procedures toinsufflate the body cavity. The trocar seal and trocar cannula is alsoconfigured to sealingly engage surgical instruments of variousdiameters, which would typically be inserted through the trocar, toprevent loss of surgical gas during use of such instruments. In oneaspect, the trocar seal housing is releasably attachable to the trocarcannula to allow the seal to be removed during surgery to enable theextraction of tissue specimens through the trocar. The trocar in oneaspect has or is included with an optical obturator having a tip, whichincludes a smooth outer surface and has a high degree of opticalclarity.

Referring now to FIGS. 1-4, the trocar seal housing 3 in one aspect canbe easily detached or removed from the trocar cannula 5 and easilyattached or re-attached to the trocar cannula 5 for example during asurgical procedure. During surgery, small tissue specimens may beextracted from a body cavity through a trocar to enable pathologicalanalysis of the tissue specimen. The integrity of the tissue specimencan be maintained or the maintenance facilitated by avoiding orminimizing withdrawal of delicate tissue specimens through a trocarseal. As such, in one aspect, the trocar seal housing 3 is arranged tobe removed from the trocar cannula 5 to enable extraction of tissuespecimens from a body cavity while maintaining the integrity of thetissue specimen. The trocar seal housing 3 also easily reattaches to thetrocar cannula 5 after its initial removal during a surgical procedure.

Also, in one aspect, the trocar seal housing 3 is easily removable fromthe trocar cannula 5 to enable rapid desufflation of an insufflated bodycavity. In one aspect, a trocar lock releasably attaches the trocarcannula to the trocar seal housing. For example, towards the end of alaparoscopic surgical procedure, release of the insufflation gas such ascarbon dioxide from the peritoneal cavity of the patient is performed.By opening one or more stopcock valves on the trocar seal, desufflationcan be achieved. The flow rate through the stopcock valves, however, canbe slow with regard to evacuation of the carbon dioxide from theperitoneal cavity and therefore the time expended to evacuate theinsufflation gas can be excessive. By removing the seal housing 3 fromthe cannula 5, the cannula provides an unobstructed outlet for theinsufflation gas to escape thereby decreasing desufflation time.

In FIGS. 5-8, two cantilever arms 7 extend from the cannula 5 whichengage mating slots 9 on the trocar seal housing 3. Each of thecantilever arms 7 has a hook 7 a on its distal end, which engages aledge 13 on the trocar seal housing 3 when the trocar seal housing 3 isattached to the trocar cannula 5. The hooks on the cantilever armsmaintain the axial position of the trocar seal housing on the trocarcannula and prevent axial dislodgment of the trocar seal housing 3 fromthe trocar cannula 5.

The cantilever arms 7 in one aspect act as leaf springs resilientlyattaching onto the trocar seal housing 3. For example, during attachmentof the trocar seal housing 3 onto the trocar cannula 5, the cantileverarms 7 flex inward until the distal ends of the cantilever arms reachslots 9 in the trocar seal housing 3. Once the distal ends of thecantilever arms 7 reach the trocar seal housing slots 9, the cantileverarms 7 spring outward such that the hooks 7 a overhang the mating ledges13 on the trocar seal housing 3. When an axial force is applied to thetrocar seal housing 3 relative to the trocar cannula 5, the hooks 7 afurther engage the ledges 13 on the trocar seal housing and do not allowremoval of the trocar seal housing from the trocar cannula. As such, inone aspect, a trocar lock comprises a pair of resilient arms 7 extendingfrom opposing sides of the trocar cannula 5 in a direction parallel to alongitudinal axis of the cannula. The pair of resilient armsoperationally engaging the pair of slots 9 on opposing sides of thetrocar seal housing 3.

To remove the trocar seal housing 3 from the trocar cannula 5, fingertabs 7 b located on the mid-portion of the cantilever arms 7 aredepressed causing the cantilever arms to move inward resulting in thedisengagement of the hooks 7 a from the housing ledges 13. The trocarseal housing 3 can thereby be removed from the trocar cannula 5 byapplying an axial force to the trocar seal housing relative to thetrocar cannula. The cantilever arms 7 on the trocar cannula 5 alsoprevent or resist rotation of the trocar seal housing relative to thetrocar cannula 5. For example, the cantilever arms 7 prevent the trocarseal housing 3 from being twisted off of the trocar cannula 5 duringmanipulation of the trocar. In one aspect, the trocar seal housing 3 isprevented from being twisted off by tabs or extended portions 18 a ofthe cannula 5 engaging recesses or slots 18 b in the seal housing 3. Thetrocar seal housing and cannula attachment can also be threaded and/orbayonet lock connections to attach the trocar seal housing 3 to thetrocar cannula 5. However, inadvertently rotating the trocar sealhousing 3 relative to the trocar cannula 5 during manipulation ofinserted instrumentation or manipulation of connected insufflation gastubing to the seal housing may result in an unintended detachment of thetrocar seal housing 3 from the trocar cannula 5. An unintendeddetachment of a trocar seal housing from a trocar cannula during asurgical procedure may result in a loss of insufflation gas, a loss ofvisibility of the operative area, a delay in the procedure, and/or otherpotential surgical issues.

The trocar cannula 5 in one aspect has a cannula seal or sealing ring 11positioned in a groove, cavity or gland 12 at its proximal end whichforms a seal with the inside diameter of the trocar seal housing. In oneaspect, a gland is an o-ring cavity and includes the portion of thecavity, e.g., portions of the trocar cannula and/or housing, thatcompress the o-ring to create a seal. In one aspect, the groove 12 in aproximal end of the cannula substantially encircles an outer peripheryof the cannula 5 and a seal or the sealing ring 11 is disposed in thegroove 12. The sealing ring 11, which in one aspect comprises of ano-ring with an “o” cross section, prevents loss of pneumoperitoneumbetween the trocar seal housing 3 and the trocar cannula 5. To minimizethe friction between the sealing ring 11 and the trocar seal housing 3,an x-ring can be used rather than an o-ring. The x-ring has a generally“x” cross section and minimizes the area of contact between the sealingring and the trocar seal housing 3 resulting in a reduction of staticand kinetic frictional forces. Reducing the frictional forces betweenthe sealing ring 11 and the trocar seal housing 3 reduces the axialforce utilized to attach and/or detach the trocar seal relative to thetrocar cannula 5.

Referring now to FIGS. 9-11, a trocar lock ring 21 releasably connectsthe trocar seal housing 3 to the trocar cannula 5. The lock ring 21 isshown simultaneously in an unlocked position on the left side of thetrocar seal housing and a locked position on the right side of thetrocar seal housing 3 for simplicity and ease of discussion. The trocarlock ring 21 in one aspect is substantially cylindrical and outlines aperimeter that generally corresponds to the outer periphery of thetrocar seal housing 3. The lock ring 21 positions the trocar sealhousing between the lock ring and the trocar cannula. One or moreprojections, protrusions or tabs 23 extend from the lock ring 21. In oneaspect, one or more rectangular tabs extend perpendicularly from aninner surface of the lock ring 21 and the longitudinal axis of thetrocar cannula 5. In a lock position, the tabs 23 extend through acorresponding aperture or slot 25 in the trocar seal housing 3 and intoa corresponding groove or cavity 27 in the trocar cannula 5 therebysecuring the trocar seal housing 3 to the trocar cannula 5. The groove27 in the trocar cannula is adjacent to, e.g., below or away from theproximal end of the trocar cannula 5, the groove 12 in the trocarcannula holding the cannula seal 11. By moving or withdrawing the tab 23out of the groove 27 in the trocar cannula 5, i.e., moving the lock ring21 into an unlock position, the trocar seal housing 3 is released orallowed to be removed from the trocar cannula 5. In one aspect, the tab23 is completely movable out of the groove 27 of the trocar cannula 5,but is not completely movable out of the corresponding aperture 25 inthe trocar seal housing 3. As such, in one aspect, a trocar lockcomprises a ring 21 having a tab 23 inwardly extending towards a centerof the ring 21. The trocar seal housing 3 has an aperture 25 and thetrocar cannula having a groove 27. The tab or tabs are movable from afirst position in which the tab is engaged with the aperture, sized toreceive the tab, in the trocar seal housing 3 and a second position inwhich the tab is engaged with the aperture in the trocar seal housingand the groove, sized to receive the tab, in the trocar cannula 5.

In one operational case, the lock tab 23 protrudes through the wall ofthe trocar seal housing 3 and into the trocar cannula groove 27, lockingthe trocar seal housing 3 to the trocar cannula 5. To release the trocarseal housing 3 from the trocar cannula 5, the locking ring 21 ismanipulated in specific predetermined manner to prevent accidentaloperation or unlocking of the trocar seal housing 3 from the trocarcannula 5. The manipulation of the locking ring 21 causes the lock tab23 to be directly or indirectly withdrawn from the groove 27, thusallowing removal of the trocar seal housing 3 from the trocar cannula 5.

The locking ring in one aspect is arranged with external grip tabs 29flushed with or extended on an outer surface of the lock ring 21 andpositioned on opposing sides of the ring. The grip tabs 29 in one aspectare also positioned on the outer surface of the lock ring 21. In oneoperation, squeezing the tabs 29 together in the direction shown deformsthe lock ring 21 to a generally oval shape manipulates the locking ringand causes withdrawal of the tabs 23 from the groove 27. The grip tabs29 in one aspect are protected from accidental operation by beingpositioned under a ledge 28 projecting from the trocar seal housing 3.

In one aspect, as shown in FIG. 12, the locking ring 21 is generallycylindrical and close-fitting to the trocar seal housing 3 with thelocking ring 21 having one or more sections forming a portion of thecylinder. One or more projections or tabs 23 extend from the one or moresections of the locking ring 21 towards the seal housing 3. In oneaspect, a portion of the locking ring 21 has three sections 22 a,b,ceach connected successively to each other via living hinges, wallshaving curved cavities allowing the sections to move away from thecenter of the locking ring 21. One of the sections, section 22 a isconnected to the remaining portion 22 d of the locking ring 21 at abouta mid-point of the remaining portion 22 d and another section, section22 c is connected to another end of the remaining portion 22 d of thelocking ring 21 near the external or outer surface of the locking ring21. The other section, section 22 b is connected between the twosections, sections 22 a and 22 c. One of the sections, section 22 a hasa projection or tab 23 extending perpendicularly from the sectiontowards the seal housing 3 to engage the seal housing aperture 25 andthe cannula groove 27. The other section, section 22 c, has grip tabs 24extending from an outer surface of the section 22 c. In one operation,as shown by the direction arrows, by squeezing one of the sections,e.g., section 22 c, inwards towards the center of the locking ring 21causes the adjoining two sections, sections 22 a,b to move or rotateoutwards away from the seal housing 3 and cannula 5, thereby pulling orwithdrawing the tab 23 from the cannula groove 27. As such, the trocarseal housing 3 is unlocked or can be removed from the trocar cannula 5.

In FIGS. 13-14, in one aspect, the locking ring 21 is rotatable closelyaround the seal housing 3. The locking ring 21 has an axial split 26 band one or more lock tabs 23 extending from the locking ring 21. Theaxial split provides for an easily molded part with a single element perring and allows the ring 21 to flex and thereby facilitate rotation. Theseal housing 3 in one aspect has a ramp 3 a adjacent to the seal housingaperture 25 to facilitate rotation and thus withdrawal of the tab 23.Grip tabs 26 a extending along a portion or portions of the externalsurface of the locking ring 21 facilitates manipulation of the lockingring 21. The lock ring in one aspect is arranged with multiple localslots or slits 26 c that create or act as a leaf spring 26 d to flexiblyhold or bias the lock tabs 23 towards the seal housing aperture 25 andcannula groove 27.

In FIG. 15, the lock ring 21 in one aspect pivots or tips about an axis24 a perpendicular to the main or longitudinal axis 24 b of the trocarcannula 5. One or more pivot pins 26 e extend from or into the lockingring 21 connecting the lock ring 21 to the seal housing 3 and providingpivot points and a pivot axis generally perpendicular to thelongitudinal axis 24 a of the trocar cannula 5. As the lock ring pivotsor tips, as shown by the direction arrow, for example, the lock tabs 23extending therefrom engage or withdraw the trocar cannula groove 27 andseal housing aperture 25. A grip tab 26 f extending from the externalsurface of the locking ring 21 assists in manipulating the ring 21. Inone aspect, a plurality of lock rings and associated tabs and grips or acombination of lock rings described above are used to releasably securethe trocar seal housing 3 to the trocar cannula 5. As such, in oneaspect, a trocar lock comprises a ring 21 having a tab 23 inwardlyextending towards a center of the ring 21. The trocar seal housing 3 hasan aperture 25 and the trocar cannula having a groove 27. The tab ortabs are movable from a first position in which the tab is engaged withthe aperture, sized to receive the tab, in the trocar seal housing 3 anda second position in which the tab is engaged with the aperture in thetrocar seal housing and the groove, sized to receive the tab, in thetrocar cannula 5.

Referring now to FIGS. 16-18, the trocar cannula 5 with a seal 11, suchas an o-ring or x-ring, e.g., an elastomeric ring with an x-shapedcross-section, situated in a groove 12 in the cannula 5 with areleasable bayonet lock 30 is shown. The cannula 5 also has one or morepins or tabs 33 that project radially out from an external surface ofthe cannula away from the longitudinal axis of the cannula 5. The pins33 engage slots 31 in the seal housing such that as the pins move withinthe slots, the cannula is rotated (approximately 90° or a quarter of onerevolution). Once the cannula 5 has been turned, the pins 33 aresurrounded top and bottom, thus locking the cannula 5 to the sealhousing 3. The slots 31 in one aspect starts with a ramped or curvedopening extending parallel to the longitudinal axis of the cannula andcurving towards a generally horizontal direction into a ramped end 31 awith a small detent at the end of the ramp.

A cannula seal in one aspect is arranged such that it is axiallycompressed as the cannula rides up the ramp 31 a. This adds friction,which helps prevent the cannula 5 and seal housing 3 from becomingseparated unintentionally. However, with the added friction, having toovercome this friction can cause removal of the trocar seal housing fromthe trocar cannula to be difficult. A bayonet type attachment withoutadditional friction, such as provided by axial seal compression, canreduce the effectiveness of preventing unintended detachment of the sealhousing 3 from the cannula 5 during surgery as the instruments aremanipulated through the trocar.

In FIG. 19, the lock tab 35 prevents or resists rotation of the sealhousing 3 and thus guards against unintended detachment of the sealhousing 3 from the trocar cannula 5. As such, the lock tab 35 ismanipulated before the seal housing can be rotated and detached. In oneaspect, the lock tab 35 is arranged as a leaf spring integral to theseal housing 3 with a grip tab 38 extending from the outer surface ofthe lock tab 35. The lock tab 35 has a cavity arranged to engage the pin33 extending from the trocar cannula 5 thereby securing the trocar sealhousing 3 to the cannula 5. The lock tab 35 is deflected distally, e.g.,pivoted, towards slot 37 in the seal housing to move the tab 35 out ofthe path of the pin 33 extending from the cannula 5. With the lock tab35 out of the path of the pin, the seal housing can be rotated andremoved from the cannula. As such, in one aspect, a trocar lockcomprises a post or pin 33 extending from an external surface of thetrocar seal cannula. A slot or slots 31,37 are in the trocar sealhousing and a resilient arm or lock tab 35 in the trocar seal housing 3is adjacent to the slot or slots. The lock tab 35 is movable towards orin a longitudinal direction. As shown in FIG. 20, the lock tab 35 in oneaspect comprises a plurality of leaf spring latches 34 integral to thecannula 5 having one or more projections or tabs 32 also extending fromthe cannula 5. The latches are releasably engagable with the aperturesor slots 39 in the seal housing 3. The latches 34 are squeezed towardseach other, as shown for example by the direction arrows, using griptabs 36 moving the projections 32 out of the slots 39 in the sealhousing 3 and thereby allowing the seal housing to rotate and be removedfrom the cannula 5.

Referring to FIG. 21, the trocar cannula 5 with a seal 11, such as ano-ring or x-ring, situated in a groove 12 in the cannula with areleasable socket lock 40 is shown.

In one aspect, the cannula 5 has a plurality of apertures or slots orsimilarly situated groove 27 adjacent to the sealing groove 12 in thecannula 5. Socket lock 40 engages the apertures or groove in the cannula5 to releasably secure the trocar seal housing 3 with the cannula 5.

In one aspect, the socket lock 40 comprises a plurality of generallycircular or cylindrical beads or balls 43. One or more balls 43 protrudethrough the seal housing 3 and into the cannula groove 27, securing thetrocar seal housing 3 to the trocar cannula 5. The balls 43 are held inposition by a close fit collar 41. The collar 41 is arranged with twoinside diameters 42 a,b such that when the collar 41 is moved axially,the balls 43 are free to retract into the larger of the two insidediameters 42 b, freeing the attachment of the seal housing 3 from thecannula 5. In one aspect, the collar is generally cylindrical having afirst proximal portion 44 a with a first diameter 42 a and a seconddistal portion 44 b with a second diameter 42 b. The first diameter 42 agenerally corresponds to the diameter of the proximal end of the cannulaand is smaller than the second diameter 42 b. The second portion 44 b isfarther away from the proximal end of the cannula 5 than the firstportion 44 a of the collar 41. The collar 41 in one aspect comprises aramp 44 c connecting the two portions 44 a,b and thus the insidediameters 42 a,b which assists or facilitates the balls from moving ordriving inwardly to the locked position when the collar is moved back tothe original position. A return spring 45 axially in-line with alongitudinal axis of the trocar cannula 5 and connected to collar 41provides a force to bias the collar towards the lock position therebyproviding protection against unintended operation and automatic closureor locking of the seal housing 3 onto the cannula 5. As such, in oneaspect, the trocar lock comprises a collar 41 and a plurality of balls43 connected to the collar 41. The balls 43 are engagable withcorresponding apertures in the trocar seal housing 3 and the trocarcannula 5. A return spring 45 connected to the collar 41 biases thecollar 41 towards a distal end of the trocar cannula 5.

In one aspect, a third or additional proximal portion 44 d of the collar41 along with projections 46 a from the seal housing 3 secure the returnspring 45 to the collar and the seal housing 3. A retainer 46 b, such asa snap or split ring, in conjunction with the second or distal portion44 b of the collar 41 secures the collar 41 to the seal housing 3 andthe balls 43 when positioned in contact with the second portion 44 b.Grip tabs 47 in one aspect extend from an outer periphery of the collarto facilitate manipulation of the collar 41. Ramps or cuts 48 adjacentto or part of the apertures 49 of the seal housing 3 facilitate movementof the balls 43 into the locking position or engagement with the sealhousing 3.

In one aspect, the balls 43 are loose secured between the collar 41 andseal housing 3. The balls 43 are spaced from each other along aperimeter around the cannula to provide additional strength and reduceunwanted motion. The lock balls 43 in one aspect are spherical,cylindrical, barrel-shaped or otherwise curved. The balls in one aspectare equally spaced or irregularly or randomly spaced. Positioning theballs towards each other, for example, providing two sets of two balls,however can assist in plastic molding operations as this eliminates orreduces the need for slides, which can simplify the mold of the trocarcannula 5 with apertures 27′ as shown in FIG. 22. In one aspect, theballs are provided as a molded ring 143 incorporating generallyspherical, cylindrical, barrel-shaped or generally curved components 43′movable as loose balls as shown in FIGS. 23-24. Such a molded ring canreduce cost and aid in assembly operations. As such, a ring 143 in oneaspect connects the plurality of balls 43 to each other.

In one aspect, the socket lock 40 engages a plurality of discreteapertures 27′ in the cannula 5 as shown in FIG. 25 instead of acontinuous groove 27. As such, the balls 43 when engaged with theapertures 27′ would be locked rotationally as well as axially. However,a continuous groove avoids having to orientate or align the lock withthe cannula to first mate the components together.

In one aspect, to protect against unintended operation, a second motionis utilized before the collar 41 is retracted axially. As such, in oneaspect, a latch is depressed before the collar 41 can be moved and, inone aspect, the collar 41 is first rotated before being able to bewithdrawn axially. In FIG. 26, the collar 41 has one or more tabs 144extending from the collar parallel to the longitudinal axis of thecannula 5. The collar 41 travels or rotates within a groove or channel149 b to engage/disengage slots 149 a in the seal housing 3 or a slots149 a in a ledge extending from the outer periphery of the seal housing3. In one aspect, the groove 149 b extends along the periphery of thecollar 41. As such, to first activate the release or unlocking of theseal housing 3 from the trocar cannula 5, the collar 41 is rotated toalign the tabs 144 with the slots 149 a to allow axial movement of thecollar 41. Axially movement of the collar 41 subsequently allows thereleasing of the seal housing 3 from cannula 5. Grip tabs 145 in oneaspect extending from the collar 41 in-line or adjacent to the tabs 144facilitate movement of the collar 41.

In one aspect, the return spring 45 also acts as a torsion spring whenthe collar is rotated before it can be retracted. For example, thespring is of a wound wire construction or a molded plastic part. In oneaspect, the return spring 45 comprises a single large coil springproviding two biases, axially and rotationally, as shown for example bythe direction arrows in FIG. 27 or multiple springs arranged axially atintervals around the inside of the collar. Multiple springs in oneaspect are arranged to deflect sideways when the collar is rotated, thusacting as a torsional return spring.

Referring to FIGS. 28-30, the trocar cannula 5 with a seal 11, such asan o-ring or x-ring, situated in a groove 12 in the cannula 5 with agate lock 50 is shown. In one aspect, the gate lock 50 engages a pair ofparallel grooves 27 in the cannula 5. The gate lock 50 is a generallyflat plate 51 with a keyhole-shaped aperture 53 through the plate. Thekeyhole-shaped aperture has a narrow portion 53 a and wide portion 53 b.As such, in one aspect, the trocar gate lock 50 comprises asubstantially flat plate 51 having a keyhole slot 53 with a firstaperture 53 a being smaller than a second aperture 53 b. The gate lock50 slides from side to side in relation to the longitudinal axis of thetrocar cannula 5. When the narrow portion 53 a of the gate lock 50engages the trocar seal housing 3, portions of the flat plate 51 orsubstantially planar tabs extending from the plate engage the groove 27in the trocar cannula 5 thereby securing the trocar seal housing 3 tothe trocar cannula 5. By moving or sliding the gate lock 50 in theopposite direction or extreme, the narrow portion 53 a of the gate lockdisengages the trocar cannula 5 as the seal housing 3 is positioned inthe wide portion 53 b of the gate lock 50. The gate lock 50 remainsengaged with the trocar seal housing 3 via, for example, a groove orslot, but is removed or withdrawn from the groove 27 in the trocarcannula 5. Thus, the seal housing 3 can be removed from the trocarcannula 5. As such, the flat plate of the gate lock 50 in one aspect ismovable in a direction perpendicular to a longitudinal axis of thetrocar cannula from a first position in which the trocar seal housing iswithin the first aperture 53 a and a second position in which the trocarseal housing is within the second aperture 53 b. The flat plate 51 beingin the first position engages with an aperture in the trocar sealhousing 3 and the groove in the trocar cannula 5 and in a secondposition in which the flat plate 51 is engaged only with the aperture inthe trocar seal housing 3.

In one aspect, the gate lock 50 is fitted with a return spring ordetents to bias the gate lock 50 to one position, e.g., locked, versusanother position, e.g., unlocked. In one aspect, the aperture 53 in thegate lock is generally round or oval in shape with one or moreprojections or detents 55 extending to the center of the gate lock asshown in FIG. 31.

Referring to FIGS. 32-33, the trocar cannula 5 with a seal 11, such asan o-ring or x-ring, situated in a groove 12 in the cannula 5 with alever lock 60 is shown. In one aspect, the lever lock 60 engages agroove or slots 27 in the cannula 5 to secure the seal housing 3 to thecannula 5. The lever lock 60 has one or more lever arms 63 with one ormore projections or tabs 61 operationally engaged with a correspondinggroove or slots 27 in the trocar cannula 5. The trocar seal housing 3has a corresponding apertures or slots 25 extending through a sidewallof the trocar seal housing 3. The tab 61 of lever lock 60 when engagedwith the groove 27 in the trocar cannula 5 through the slot in the sealhousing 3 secures the trocar seal housing to the cannula 5. The leverarms 63 are attached to the seal housing via a pivot pin 65 extendingfrom/to one end of the lever arms 63 to/from the seal housing 3.Rotating or pivoting the lever lock from out of a substantiallyhorizontal position as shown for example by the direction arrows causesthe tab 61 of arm 63 to withdraw from the groove 27 in the trocarcannula 5 and/or the aperture 25 in the trocar seal housing 3. Thus, theseal housing 3 can be released from the trocar cannula 5. In one aspect,the lever arms 63 are arranged with a pivot axis 64 a parallel to thelongitudinal axis 62 of the cannula 5 or in one aspect with a pivot axis64 b at 90 degrees to the cannula longitudinal axis 62 as shown in FIG.34. In one aspect, multiple lever locks are attached to the seal housing3 and are arranged in like orientations or as mirror images as forexample shown in FIG. 35. As such, in one aspect, the trocar lock 60comprises at least one lever arm 63 pivotably movable relative to thetrocar seal housing 3 and having a tab 61 extending from the at leastone lever arm. The at least one lever arm is movable from a firstposition in which the tab engages with the aperture in the trocar sealhousing 3 and the groove in the trocar cannula 5 and a second positionin which the tab 61 is engaged only with the aperture in the trocar sealhousing 3 or is substantially withdrawn from the groove in the trocarcannula 5.

Referring to FIG. 36, the trocar cannula 5 with a seal 11, such as ano-ring or x-ring, situated in a groove 12 in the cannula 5 with a latchlock 70 is shown. In one aspect, the latch lock 70 are twin leaf springlatches 71 integral or attached to the cannula 5 with tabs orprojections 77 that engage apertures or slots 25 in the seal housing 3to secure the seal housing 3 to the cannula 5. The latches 71 aremanipulated, e.g., squeezed, to withdraw the latches out of the slots 25in the seal housing thereby allowing the seal housing 3 to be detachedfrom the cannula 5. Grip tabs 73 extending from the latches 71 assist inmanipulation, e.g., squeezing, of the latches. As such, the trocar lock70 comprises at least one latch with a tab 77. The at least one latch ismovable from a first position in which the tab 77 engages with theaperture in the aperture in the trocar seal housing 3 and the groove inthe trocar cannula 5 and a second position in which the tab 77 iswithdrawn from the groove in the trocar cannula 5.

In FIG. 37, the latch arm 71 has a bulbous head 75 that engages orsprings into a recessed area or curved cavity 25′ of the seal housing 3.The latch lock 70 in one aspect accommodates both tensile andcompressive loads between the seal housing 3 and cannula 5 and thereforeserves to position the parts in relation to each other. Additionalsecondary ledges or stops may also be used to further enhance thelocking of the seal housing 3 to the cannula 5. The radii or curve atthe top and bottom of the bulbous head 75 assists the latch lock 70 inengaging and disengaging, e.g., hook and unhook, from the seal housing3. The recess 25′ in the seal housing allows the latch lock 70 to beaccessed without protruding from the seal housing 3. A release buttonthat protruded could be unintentionally squeezed during normal surgicalprocedures, possibly resulting in unintended detachment of the sealhousing 3 from the cannula 5. The functional or manipulated area 78 ofthe latch lock 70 relative to the cannula 5, for example, the areaallowing the latch lock to flex, in one aspect is larger than theportion of the seal housing 3 that contacts the cannula seal 12. In oneaspect, the seal housing 3 inner walls are tapered, ramped or curved. Assuch, the cannula seal is protected as the cannula 5 passes the latchslots or aperture 25′ in the seal housing 3.

In FIG. 38, the latch lock 70 has generally triangular shaped latchheads 79. The triangular shaped latch heads 79 increase or assist indeflection of the latch lock 70 when mating the seal housing 3 andcannula 5. For example, the user would not need to hold the latch openas the parts are mated. The flat bottom 76 of the latch lock 70 ensuresa positive lock while requiring a minimum of clearance to achieve thelock. An angled or overlapping latch can provide a more positive lockbut may introduce more travel or play between the cannula 5 and sealhousing 3. The latch lock 70 comprises of resilient or latches armsarranged external to the cannula seal lumen of the seal housing. Assuch, the cannula seal 11 and locking tabs or heads are generally in thesame horizontal plane, resulting in a shorter seal to cannula joint. Ashorter seal can be desirable for cost and ergonomic considerations. Thelatch lock 70 is tensile capable and as such the seal housing 3 isarranged to bottom out on the horizontal portion 76 of the latches 71.

Referring now to FIGS. 39-40, trocar seal housing 3 holds or encloses aninstrument or septum seal 101 and a zero seal 103, e.g., a duckbillseal. The septum seal 101 and the zero seal 103 are coaxially alignedwith each other and a longitudinal or central axis of the trocar cannula5 and seal housing 3. The septum seal 101 has an aperture with itscenter substantially in-line with the center of the trocar seal housing3 and/or cannula 5. The septum seal 101 forms a seal to maintainpneumoperitoneum around instruments inserted through the seal's aperturewhile the zero seal 103 forms a seal to maintain pneumoperitoneum whenno instrumentation is present in the trocar seal housing 3 and/or trocarcannula 5. The septum seal 101 in one aspect is free to swing at itsdistal end in response to the insertion of instrumentation or inresponse to the manipulation of inserted instrumentation. In one aspect,the septum seal pendulates. For example, the septum seal at its distalend moves along generally curved line or arc in response to theinsertion of instrumentation or in response to the manipulation ofinserted instrumentation. In one aspect, excess material, levers,bellows, convolutions or other such means pivotally connect theinstrument or septum seal 101 to the trocar seal housing 3.

In one aspect, the zero seal 103 is fixed in place in contrast to theseptum seal 101. In one aspect, the septum seal 101 is pivotallyattached to the seal housing 3 and substantially encompassed in thefixed zero seal 103. In one aspect, the zero seal 103 is a duckbill sealfixed to the trocar seal housing 3. As such, the zero seal 103 does notswing or pendulate to a large degree, if any, relative to the septumseal 101. The zero seal 103 in combination with the septum seal 101enables the trocar to accommodate a wide range of instrumentationdiameters while minimizing the overall size of the trocar seal housingand trocar cannula.

A pendulous septum seal 101 with a zero seal attached to the pendulousseptum seal can also be provided, such that pendent movement of theseptum seal results in pendent movement of the zero seal. However, sucha pendent trocar seal configuration can utilize a large amount of spaceto be accommodated within the trocar seal housing 3 and the trocarcannula 5 to enable the pendent movement of both the septum seal and thezero seal. This may result in a trocar seal with a relatively largeaxial length and overall diameter. The pendent septum seal 101 and afixed zero seal 103 allows the trocar seal housing 3 and trocar cannula5 to be sized with a reduced axial length and a reduced diameterrelative to other trocar seals.

In one aspect, an instrument alignment channel 105 is juxtaposed to theseptum seal 101. The alignment channel 105 in one aspect issubstantially fixed and/or rigid. In one aspect, the alignment channel105 is a long tubular channel, which extends from the proximal openingof the trocar seal to above the aperture in the septum seal 101. Thealignment channel 105 serves to align or guide instrumentation duringinsertion and manipulation. By aligning the instrumentation andrestricting the degree to which instrumentation can be manipulated, thealignment channel 105 decreases the likelihood that instrumentation cancatch, tear, or otherwise disrupt the septum seal 101. Also, thealignment channel being fixed restricts the degree to which an insertedinstrument can be manipulated. As such, the degree of pendulous movementutilized to accommodate instrumentation with a wide range of diametersis decreased and also the size of the trocar seal can be more compact.

The alignment channel 105 in one aspect also enables the size of theseptum seal aperture to be increased. For example, the aperture in theseptum seal 101 is sized to prevent eat-eye leakage during extremelateral movement of the instrumentation. However, with a fixedinstrument alignment channel 105, which is juxtaposed the septum seal101, lateral movement of inserted instrumentation is restricted and apendulous septum seal 101 accommodates the small amount of lateralinstrumentation movement allowed by the alignment channel 105. As such,the aperture in the pendulous septum seal can be enlarged and/ortolerances relaxed. The increased diameter of the septum seal apertureresults in a reduction in the drag force produced during axial movementof inserted instrumentation. A reduction in instrumentation drag forcefor trocar seals can aide with positioning of instrumentation relativeto the operative tissue. A reduction in instrumentation drag force alsodecreases the likelihood that a trocar seal housing 3 and cannula 5 willbe dislodged from a body wall during withdrawal of an instrument. Areduction in instrumentation drag force can also result in less fatiguefor the surgeon, for example, during complex surgical procedures.

In one aspect, the alignment channel 105 has a proximal end, a distalend, and a body portion 106 a extending between the proximal end and thedistal end. The distal end extends into an outwardly tapered exit. Inone aspect, the alignment channel 105 has an enlarged diameter at itsdistal end. The enlarged diameter allows for inversion of the septumseal 101 adjacent to the alignment channel 105 and prevents binding ofthe septum seal between the alignment channel and an instrument. Forexample, during withdrawal of an instrument, the septum seal 101 mayinvert and pull into the alignment channel 105. In one aspect, if thealignment channel 105 is not sufficiently sized, a binding or lock upeffect may occur which can prevent further withdrawal of the instrument.The alignment channel 105 in one aspect has a first diameter along itsbody portion 106 a to align instruments and to prevent excessive lateralmovement of the inserted instruments. The alignment channel 105 in oneaspect has a second diameter at its distal end 106 b, which is largerthan the first diameter. The second diameter is sized such that it canaccommodate a two wall thicknesses of the septum seal and/or the largestinstrument diameter that can pass through the first diameter of thealignment channel. The axial length of the enlarged diameter distal end106 b is sized such that the septum seal 101 can invert but not extendinto a body portion 106 a of the alignment channel with a smallerdiameter portion of the alignment channel 105.

The alignment channel 105 in one aspect has an entry 107 at its proximalend that aids with insertion of instrumentation and serves to guideinstrumentation into the alignment channel 105. In one aspect, the entryis generally funneled and/or tapered. As such, in one aspect, thealignment channel 105 has a proximal end and a distal end. The proximalend extends into an outwardly tapered entry. In one aspect, the taperedentry has a diameter that is larger than the diameter of the outwardlytapered exit. In one aspect, the entry has a matte finish or provides ananti-reflective or non-glare finish, coating or layer. Theanti-reflective entry prevents or reduces glare and/or light from alaparoscope from being reflected back or towards the user. The entry inone aspect has a guard rail 109 at the proximal portion of the entry.The guard rail 109 in one aspect comprises a raised wall which generallyencircles the top or external surface of the entry extending parallel tothe longitudinal cannula axis from an end cap or wall 110 of the trocarseal housing 3. In one aspect, the trocar seal housing 3 has opening inan end cap of the trocar seal housing and an alignment channel 105extends from the end cap 110. The septum seal 101 positioned between thealignment channel 105 and the zero seal 103. The zero seal 103 isadjacent to a proximal end of the cannula 5. In one aspect, the guardrail comprises a raised portion substantially outlining a periphery ofthe generally funneled entry 107. In one aspect, the guard railintegrated with or separate from the entry 107 and is a raised portionsubstantially outlining a periphery of an opening in a proximal end ofthe seal housing 3. The guard rail 109 provides a tactile hard stop tolimit or prevent a surgeon from laterally sliding an instrument out ofthe entry 107 or alignment channel 109 during insertion of an instrumentinto the trocar seal housing 3.

Referring to FIG. 41, in one aspect, the pendulous septum seal 101 isprotected with a sleeve or shield 108 that is nested into the septumseal 101 and pivots with the septum seal 101. The shield preventsinstruments from catching and/or tearing the septum seal. The shield 108can also prevent the septum seal from inverting during instrumentwithdrawal and in one aspect is a polyethylene sleeve. The shield 108can also reduce the instrumentation drag force and in one aspect is usedin combination with the instrument alignment channel 105. The shield 108in one aspect partially surrounds the alignment channel 105. In oneaspect, the shield 108 is positioned axially between the alignmentchannel 105 and the septum seal 101. In one aspect, the shield 108extends along the septum seal 101 between the alignment channel 105 andthe septum seal 101.

In one aspect, a trocar seal housing 3 has a stopcock body 112. Forexample, the trocar seal housing has an integrally luer fitting inlet ormolded integral luer fitting 111 and a snap fitted stopcock body 112.The stopcock body 112 in one aspect comprises a center bore and a lever.The trocar seal housing 3 with the integral luer fitting 111 isinjection molded with polycarbonate. The stopcock body 112 is injectionmolded with polyethylene. The stopcock center bore in one aspect has abarb 114 at its distal end, which engages with a shelf on the integralluer fitting 111 to secure the stopcock body to the integral luerfitting. The trocar seal housing 3 in one aspect can have a separatelyassembled stopcock/luer fitting, which is then bonded or ultrasonicallywelded to the trocar seal housing 3 (e.g., FIG. 42). However, as shownin FIG. 41, with the trocar seal housing 3 with an integrally moldedluer fitting and stopcock body, bonding or welding the stopcock can beavoided thereby eliminating at least one assembly process and one moldedcomponent thereby reducing the overall cost to produce the trocar seal.In one aspect, the integral luer fitting 111 is incorporated with andextends from the trocar seal housing 3 in a first direction for a firstdistance. The first direction is substantially perpendicular to alongitudinal axis of the trocar cannula 5. The stopcock 112 has acentral bore extending substantially parallel to the longitudinal axisof the trocar cannula 5 and is fitted into the integral luer fitting111. The stopcock 112 also has a lever movable by a user and extends ina second direction for a second distance. The first directioncorresponds to the second direction and the first distance correspondsto the second distance.

In one aspect, the trocar seal housing 3 has an aperture with a centerpositioned along a first axis and is arranged to communicate gas to thetrocar cannula 5. The first axis is substantially perpendicular to alongitudinal axis of the trocar cannula. The integral luer fitting 111has an aperture with a center positioned along the first axis and isarranged to be coupled to an insufflation gas line. The stopcock 112 hasa central or center bore that has a first aperture with a center and asecond aperture with a center. The center bore is movable from a firstposition to a second position. In the first position, the center of thefirst aperture and the center of the second aperture are substantiallyaligned with the first axis. In the second position, the center of thefirst aperture and the center of the second aperture are out ofalignment with the first axis. Examples of trocars with stopcocks orconfigurable with stopcocks are described in U.S. patent applicationsSer. No. 10/264,550, filed Oct. 4, 2002, Ser. No. 11/000,123, filed Nov.30, 2004, and Ser. No. 10/776,387, filed Feb. 10, 2004, and U.S.Provisional Patent Application Nos. 60/529,455, filed Dec. 12, 2003,60/492,949, filed Aug. 6, 2003, 60/312,683, filed Aug. 14, 2001, theentire disclosures of which are hereby incorporated by reference as ifset in full herein.

In one aspect, as shown for example in FIGS. 44-46, a luer fitting isintegrated with a stopcock lever to form a spigot 120. With thisconfiguration, the spigot 120 can double as a handle. As such, thespigot 120 can rotate from a high profile position to a low profileposition reducing the overall profile of the trocar seal. A reducedtrocar seal profile allows for greater manipulation of the trocar andenables trocars to be more closely spaced on a body wall. For example,the trocar seal housing with an integrated or combined stopcock leverand luer fitting provides a reduced “footprint” (plan view) or the areataken up by the trocar.

In one example, in a laparoscopic surgery three to five trocar ports canbe used. Each trocar is provided with a stopcock. However, only onetrocar has an open stopcock with an insufflation line attached. Thestopcocks on the other the trocar are not used and are therefore closed.As shown for example in FIGS. 42-43, even though the levers are in theclosed position, however, the luer inlet fitting still extends outwardlyfrom the seal and so increases the space occupied by the trocar. Inaddition, the lever may only be swung 90 degrees to either side and dueto geometry conditions, the lever still projects out from the trocar. Assuch, a closed stopcock can occupy more space than an open stopcock astwo objects project outwardly from the trocar. Also, a fixed luer inletfitting on a trocar can contact the patient's skin during extrememanipulation of the trocar, which can restrict instrument manipulationor trauma to the skin.

In one aspect, a separate stopcock/luer inlet assembly added to thetrocar seal housing can result with the stopcock protruding about 1⅛″from an approximate 1″ diameter seal. This changes the footprint to anapproximate 1″ by 2⅛″ oval versus an approximate 1″ circle for anon-stopcock version. In one aspect, a trocar seal housing 3 integratesthe stopcock bore and luer fitting inlet into the housing. This reducesthe overhang by about ¼″, reducing the footprint. Also, at least onepart and at least one assembly operation is eliminated. Overhang is alsoreduced to about ⅞″ versus about 1⅛″. In one aspect, a trocar sealhousing 3 is provided which eliminates a fixed inlet 111 which protrudesfrom the trocar housing even when the valve lever is turned parallel tothe body of the trocar housing (off position). In one aspect, thestopcock/inlet assembly is transformed into a combination lever andfitting, spigot 120. In the “off” position, the spigot 120 protrudesabout ⅜″ or so from 1″ diameter housing, as the spigot can be turnedpast about 90 degrees to lay alongside the housing. In one aspect, thetrocar cap traps the spigot in a valve bore when assembled. As such, acap ledge in one aspect is provided above the spigot.

The spigot 120 with a reduced profile, especially when it is not in useand therefore closed, in one aspect, comprises a combined lever and luerinlet fitted to pivot to the trocar seal housing 3. In the openposition, the spigot extends directly outward from the housing 3 andoccupies an area similar but less than a stopcock and luer inletfitting. When the spigot 120 is swung to the closed position, it liesclosely alongside the trocar housing 3 and occupies a reduced area. Inparticular, no luer inlet fitting protrudes outwardly from a closed andunused fitting. In one aspect, the spigot 120 is fitted to a closedended pivot bore 121 and is retained by a ledge 122 extending locallyfrom the seal housing 3 or an end cap of the seal housing 3. On theother end of the spigot 120, an insufflation gas fitting end 125, e.g.,a threaded end, operationally connects to an insufflation gas line. Nearthe closed ended pivot bore, a insufflation outlet aperture or hole 126provides gaseous communication between the inlet or insufflation fittingend 125 and the cannula via associated apertures or channels provided inthe cannula 5 and seal housing 3. The opposing end of the closed endedpivot bore has a pivot pin extending into the ledge 122 securing thespigot 120 in a pivotable relation with the seal housing 3. A hole oraperture 127 may be provided on the seal housing adjacent to spigot 120to facilitate molding of the seal housing components.

To prevent unintended rotation, in one aspect, one or more detents 123engaging with a corresponding cavity 124 on the end cap or wall orextended ledge 122 are provided to retain the spigot 120 in a particularpositions, e.g., open and closed. In one aspect, the lever is able torotate more than 90 degrees so as to be positioned more closely alongthe seal housing and therefore occupy as little space as possible. Withthe spigot 120 swung over alongside the seal housing, skin contact isdiminished. As such, in one aspect, a pivotable spigot 120 is connectedto the trocar seal housing 3. The spigot 120 has an insufflation gasfitting on one end 125 and movable between a first position to positionthe gas fitting extending away from and/or perpendicularly to alongitudinal axis of the trocar cannula 5 and the trocar seal housing 3and a second position to position the gas fitting extending close toand/or positioned substantially near the seal housing 3.

Referring now to FIGS. 47-49B, an optical obturator 10 in one aspect isconfigured to separate muscle fibers and tissue during placement of thetrocar across a body wail. The trocar seal housing 3 and cannula 5 withthe inserted obturator 10 is alternately twisted back and forth as asmall axial force is applied to traverse a body wall. The crosssectional profile of the obturator tip 10 a is configured such that itswidth is greater than its length. Rotation of the obturator 10 causesmuscle fibers and tissue to separate along natural planes. The opticalobturator 10 in one aspect is formed of a transparent high-flowpolycarbonate material to enable visualization of tissue fibers duringtraversal across a body wall. Visualization can be achieved by insertinga laparoscope with an attached camera into the inside diameter of theobturator 10. The tissue is viewed through the tip 10 a of the obturatoras the trocar traverses a body wall. In one aspect, a laparoscope isallowed to be positioned within a portion of the obturator tip 10 aenhancing visualization. Referring to FIG. 49B, in one aspect, theobturator 10 has a longitudinally extending lumen 10 g from a proximalopen end 10 e to a distal closed end 10 f. The lumen 10 g is sized andarranged to receive a laparoscope and the obturator 10 is sized to beslidably movable in the lumen of the trocar cannula 5.

In one aspect, the tip portion of the obturator is molded. The injectionmold for the obturator is configured such that the distal tip of theobturator, which in one aspect is the portion that contacts andseparates body wall tissue, does not include any mold parting linesand/or injection molding gates. The tip 10 a therefore is smooth with ahigh degree of clarity and is free of any artifacts produced as a resultof injection molding such as parting line flash, parting line mismatch,gate recesses, gate remnants, and gate blush. An optical obturator 10with these artifacts from injection molding may catch body wall tissuesuch as the peritoneum. The image produced through the optical obturatoris also enhanced, as the tip of the obturator does not include partinglines, a gate remnant, a gate recess, or gate blush, all of which mayreduce the optical clarity of an optical obturator.

Referring now to FIGS. 50-55, the access port comprises a seal housing 3releasably attached to a cannula 5. The seal housing 5 holds a pendulousseptum seal 101, which has a convolution 115 of excess material at itsproximal end. The convolution 115 enables the septum seal 101 to pivotin response to the insertion of an instrument such that the septum sealcan align itself with the inserted instrument. The convolution 115 alsoallows the septum seal 101 to pivot during off-axis movement of aninserted instrument such that a seal is maintained between the septumseal 101 and the inserted instrument. The septum seal 101 is designedwith the convolution 115 such that there are no undercuts on the part.By providing a part with no undercuts, the septum seal 101 can betransfer molded with relatively simple multi-cavity mold tooling. In oneaspect, convolutions 115, excess material, levers, bellows, or othersuch means pivotally connect the instrument or septum seal 101 to thetrocar seal housing 3.

In one aspect, the trocar seal comprises a septum shield 116 adjacent tothe septum seal 101. The septum shield is arranged such that it abutsthe distal portion of the alignment channel 105. In one aspect, theseptum shield 116 has a proximal flat portion in contact with thealignment channel 105. This minimizes the axial movement of the septumshield 116 during withdrawal of an inserted instrument. The septum sealin one aspect comprises an annular rib positioned between the alignmentchannel 105 and the septum shield 116. The annular rib for example abutsthe distal portion of the alignment channel 105 and extendsperpendicular to the longitudinal axis of the trocar cannula. Theannular rib in one aspect holds the shield in place in the septumshield. In one aspect, the septum shield 116 partially surrounds thealignment channel. In one aspect, the septum shield 116 is positionedaxially between the alignment channel and the septum seal 101. In oneaspect, the septum shield 116 extends along the septum seal 101 betweenthe alignment channel 105 and the septum seal 101.

The septum seal 101 in one aspect is configured with varying wallthicknesses in the convolution portion 115 of the seal 101 to minimizeaxial movement of the septum seal 101 during the insertion or distaladvancement of an instrument. For example, the outer wall of theconvolution 115 can be configured with a thicker wall than the innerwall of the convolution 115. This would allow the septum seal 101 topivot yet would inhibit the axial movement of the septum seal 101 in thedistal direction.

The septum seal 101 in one aspect has a plurality of radially spacedvertical ribs on an outside wall or surface of the convolution 115. Theradially spaced ribs allow the septum seal 101 to pivot yet inhibits theaxial movement of the septum seal 101 in the distal direction. The mostproximal portion of the convolution 115 in one aspect is arranged tohave a thinner wall thickness than either the outer wall or the innerwall of the convolution 115. This enables the septum seal 101 to easilypivot yet inhibits the axial movement of the septum seal 101 in thedistal direction. The convolution 115 in one aspect comprises aplurality of radially spaced ribs, which would span the gap between theouter wall of the convolution and the inner wall of the convolution. Theribs would be thin enough to allow the septum seal 101 to pivot yetwould inhibit the axial movement of the septum seal 101 in the distaldirection. By minimizing or inhibiting the axial movement of the septumseal 101 in the distal direction this allows or facilitates the trocarseal to be arranged more compactly with a reduced overall height.

In various aspects, the trocar seal housing 3 has opening in an end cap110 of the trocar seal housing and an alignment channel 105 extends fromthe end cap 110. The septum seal 101 is positioned between the alignmentchannel 105 and the zero seal 103. The zero seal 103 is also adjacent toa proximal end of the cannula 5. The access port in one aspect comprisesa seal housing 3, which is releasably attached to the cannula 5 via forexample cantilever snap arms 7 to enable removal of tissue specimens andto enable rapid desufflation of a body cavity. Suture ties loops or eyes8 in one aspect are generally circular apertures extending from opposingsides of the cannula 5. The access port in one aspect accommodates ablunt optical obturator arranged to be used in conjunction with aninserted laparoscope to allow visualization of tissue during traversalacross a body wall. The optical obturator 10 in one aspect has alaparoscope lock 10 b arranged to allow rotation of the laparoscopewithin the obturator while preventing axial movement of the laparoscopewithin the obturator.

The trocar seal housing 3 and cannula 5 in one aspect comprises multiplecomponents. The trocar cannula 5 is an injection molded polycarbonate.Attached to the trocar cannula 5 is an EPDM (Ethylene Propylene DieneMonomer) O-ring seal. In one aspect, the cannula seal 11 is over-moldedseal comprising of silicone, KRATON, styrene-ethylene/butylene-styrene,copolyester, copolyamide, thermoplastic rubber, thermoplastic vulcanite,C-FLEX, or a thermoplastic elastomeric material molded into apolycarbonate trocar cannula. The trocar seal housing 3 has an injectionmolded polycarbonate housing, an injection molded polycarbonate cap, aninjection molded polycarbonate shield, a compression molded polyisopreneseptum seal 101, a compression molded polyisoprene duckbill valve 103,and an injection molded polyethylene stopcock body 112. To assemble thetrocar seal, the stopcock lever is snap fitted into the integral luerfitting 111 of the housing 3. The duckbill valve 103 is seated into thehousing 3. The septum seal 101 is nested into the duckbill valve 103.The cap is press fitted onto the housing 3. The assembled trocar sealhousing 3 is snap fitted onto the trocar cannula 5.

The optical obturator 10 in one aspect comprises three components; aninjection molded polycarbonate obturator shaft 10 d, an injection moldedpolycarbonate knob 10 c, and an injection molded polycarbonate scopelock 10 b. The scope lock retains the axial position of an insertedlaparoscope. Assembly of the obturator in one aspect comprises snapfitting the knob onto the obturator shaft. The scope lock snap fits ontothe knob.

In one aspect, the trocar cannula 5 and o-ring are formed of reusablematerials enabling autoclave sterilization and re-use of the cannula ando-ring. In one aspect, the optical obturator shaft is formed of anextruded plastic tube or a metal tube. The tip portion 10 a is bonded tothe tube or overmolded onto the tube. In one aspect, the zero seal 103is a double duckbill valve, a single duckbill, a gel seal, anoverlapping flap seal, and/or a slit seal. In one aspect, the septumseal 101 and the zero seal 103 may be coated with parylene, siliconegrease, mineral oil, glycerin, Teflon, silicone oil, or a combinationthereof to reduce instrument drag forces. The septum seal 101 and zeroseal 103 in one aspect is chlorinated or plasma etched to reduceinstrument drag forces.

In various aspects, the trocar lock is arranged to resist axial forcesdirected to separate the trocar cannula from the trocar seal housing. Inone example, a trocar lock has a tab extending from the trocar lock andis movable through an aperture in the trocar seal housing to a groove inthe trocar cannula. In one example, a trocar lock extends from thetrocar cannula and has a tab that is engagable with a slot in the trocarseal housing. In various aspects, a trocar seal housing is providedwhich easily attaches to and easily detaches from a trocar cannula, hasa pendulous septum seal with a zero seal, a fixed instrument alignmentchannel, a shield protecting the septum seal, an instrument alignmentchannel with an enlarged space to allow for inversion of the septumseal, an optical obturator with a tip that has a high degree of opticalclarity and/or with an outer surface that is smooth, or any combinationthereof. Examples of pendulous seals are described in U.S. patentapplication Ser. No. 10/264,550, filed Oct. 4, 2002, the entiredisclosure of which is hereby incorporated by reference as if set infull herein. Examples of shielded septum seals are described in U.S.patent application Ser. No. 11/000,123, filed Nov. 30, 2004, and U.S.Provisional Patent Application No. 60/529,455, filed Dec. 12, 2003, theentire disclosures of which are hereby incorporated by reference as ifset in full herein. Examples of optical obturators are described in U.S.patent application Ser. No. 10/956,167, filed Oct. 1, 2004, and U.S.Provisional Patent Application No. 60/508,390, filed Oct. 3, 2003, theentire disclosures of which are hereby incorporated by reference as ifset in full herein.

Although the present invention has been described in certain specificaspects, many additional modifications and variations would be apparentto those skilled in the art. It is therefore to be understood that thepresent invention may be practiced otherwise than specificallydescribed, including various changes in the size, shape and materials,without departing from the scope and spirit of the present invention.Thus, embodiments of the present invention should be considered in allrespects as illustrative and not restrictive.

The invention claimed is:
 1. A surgical access port comprising: a trocarseal housing comprising: at least one seal enclosed within the trocarseal housing and configured to sealingly engage surgical instruments; aclosed ended pivot bore; and a spigot fitted to the pivot bore, thespigot comprising: a stopcock lever combined with a gas fitting end, thecombined stopcock lever and gas fitting end pivotable with respect tothe pivot bore; and an outlet aperture in gaseous communication with thegas fitting end through the stopcock lever; and wherein the spigot ispivotable between a first position to position the gas fitting extendingaway from the trocar seal housing, and a second position to position thegas fitting end substantially near the trocar seal housing.
 2. Thesurgical access port of claim 1, wherein the gas fitting end comprises aluer fitting.
 3. The surgical access port of claim 1, wherein thestopcock lever is pivotable more than 90 degrees between the firstposition and the second position.
 4. The surgical access port of claim 1wherein the trocar seal housing comprises an aperture adjacent thespigot.
 5. The surgical access port of claim 1, wherein the firstposition defines an open configuration of the spigot and the secondposition defines a closed configuration of the spigot.
 6. The surgicalaccess port of claim 1 wherein the trocar seal housing further comprisesa ledge extending therefrom and positioned to retain the spigot in theclosed ended pivot bore.
 7. The surgical access port of claim 6, whereinthe trocar seal housing further comprises an end cap and wherein theledge extends from the end cap.
 8. The surgical access port of claim 6,wherein the spigot comprises a pivot pin opposite the closed end of theclosed ended pivot bore, and wherein the pivot pin extends into theledge to secure the spigot in a pivotable relation with the trocar sealhousing.
 9. The surgical access port of claim 6, wherein the ledgecomprises at least one cavity, wherein the spigot comprises a detentengageable with the cavity, and wherein the at least one cavity ispositioned to retain the spigot in a particular position.
 10. A surgicalaccess port comprising: a trocar cannula; a trocar seal housing attachedto the trocar cannula, the trocar seal housing comprising: a spigotcomprising a stopcock lever extending and providing gaseouscommunication from a gas fitting to an insufflation fluid outlet, thespigot being rotatable such that the gas fitting pivots from a highprofile position to a low profile position relative to the trocar sealhousing.
 11. The surgical access port of claim 10, wherein the gasfitting comprises a luer fitting.
 12. The surgical access port of claim10, wherein the spigot is closed in the low profile position and open inthe high profile position.
 13. The surgical access port of claim 10,wherein the spigot rotates more than 90 degrees relative to the trocarseal housing between the high profile position and the low profileposition.
 14. The surgical access port of claim 10, wherein the trocarseal housing is removably attached to the trocar cannula.
 15. Thesurgical access port of claim 10, wherein the spigot further comprises afluid communication lumen therein extending from the gas fitting to theinsufflation fluid outlet.
 16. The surgical access port of claim 10,wherein the trocar seal housing comprises a valve bore and wherein thespigot is positioned in the valve bore.
 17. The surgical access port ofclaim 16, wherein the trocar seal housing comprises an end cap having aledge extending therefrom to retain the spigot in the valve bore.